High blood pressure treatment - is it effective

High blood pressure treatment and lifestyle changes

Changing your lifestyle can be a very effective high blood pressure treatment if you are under 65 and very determined to make the changes and stick to them. Most people find that carrying a few extra pounds is one reason for mildly elevated blood pressure; changing eating habits and taking regular exercise can help keep your weight under control. Other changes that are effective include cutting out smoking, not drinking too much alcohol and reducing the amount of salt that you eat. This type of high blood pressure treatment has no side effects and will also increase your general health.

ACE inhibitors and high blood pressure treatment

One of the causes of high blood pressure is the narrowing of blood vessels throughout the body. This makes it more difficult for the heart to pump blood through the narrowed vessels. The heart works harder to compensate, so increasing blood pressure. ACE inhibitors block the action of angiotensin II, a substance that makes blood vessels narrower. Blocking angiotensin II helps to relax blood vessels and also stops the body retaining fluid; this double action makes them very effective high blood pressure treatments.

• Examples of ACE inhibitors include Captopril, Enalapril, Imidapril and Cilazapril, all of which can have different brand names.
• ACE inhibitors are suitable for people under 55 who are generally healthy and also for diabetics or people with kidney disease. This type of high blood pressure treatment does not put kidney function at risk.
• ACE inhibitors do not work as well in people who have an Afro-Caribbean background and should never be used in pregnant women.

High blood pressure treatment with angiotensin receptor blockers

Angiotensin receptor blockers (ARBs) also block angiotensin II, so work in the same way as ACE inhibitors. Both types of high blood pressure treatment are effective but different people may respond to one better than the other. Examples include Candersartan, Eprosartan, Losartan and Valsartan; these high blood pressure treatments have the same recommendations for use as the ACE inhibitors (see above).

Calcium channel blockers as high blood pressure treatment

In blood vessels, calcium tends to cause the arteries walls to tighten, reducing the space available for blood to flow and so increasing blood pressure. Calcium channel blockers allow the arteries to relax, so lowering blood pressure.

• Examples include Diltiazem, Isradipine, Amlodipine and Nicardipine (again these have various brand names).
• High blood pressure treatment with calcium channel blockers is suitable for people over 55, and for people of Afro-Caribbean origin. It can also be used in pregnant women and people with underlying health problems such as diabetes and kidney disease.

High blood pressure treatment with diuretics

Several types of diuretic are used in high blood pressure treatment in the UK. Diuretics work by getting the kidneys to work harder to remove water and salt from the body, which lowers blood pressure. Thiazide diuretics, loop diuretics or potassium sparing diuretics can all be effective high blood pressure treatments. The different types are prescribed to suit different people. Potassium sparing diuretics, for example, are best for people with low levels of potassium; other diuretics could lower their potassium levels too far.

• Examples include Bendroflumethiazide, Bumetanide and Eplerenone.
• Diuretics are a popular second or third line high blood pressure treatment – this means they can be used in combination with first line treatments such as ACE inhibitors in people whose blood pressure is not controlled completely with just one drug.

Effective high blood pressure treatment

All of the currently used high blood pressure treatments are effective and generally safe. All drugs have some side effects and the first drug you are given may not be suitable. However, because there are so many types of high blood pressure treatment available, there is always an alternative. It may take a little while for your doctor to work out the most effective high blood pressure treatment for you, but once that treatment is working well, you can relax knowing that your blood pressure is under control.

Profile of the author

Dr Kathryn Senior is an acclaimed medical journalist who has written over 500 feature articles for leading international journals within The Lancet group. As Senior Writer at Freelance Copy she produces high quality scientific and medical content for websites and printed publications for companies and organisations in the health, medical and pharmaceutical sectors.